The most common form of stomach cancer is adenocarcinoma and accounts for 95% of all stomach cancers. Adenocarcinoma starts in the glandular cells of the stomach lining.
Stomach cancer is not infectious and can’t be passed from one person to another.
Less common cancers that can start in the stomach include:
• soft tissue sarcomas, including gastrointestinal stromal tumors (GISTs)
• lymphomas, such as mucosa associated lymphoid tissue (MALT) lymphomas carcinoid tumors.
The tests and treatments for these cancers are different from the ones covered in this section.
Risk Factors that could lead to stomach cancer
Stomach cancer is more common in men than in women. Men have more than double the risk.
The risk increases as we get older – 95 out of every 100 people (95%) who develop stomach cancer are over 50 years old.
Helicobacter pylori (H. pylori) infection
This is a common stomach infection that causes inflammation of the stomach lining. Over a long time, it can increase the risk of a cancer developing. People with stomach symptoms are now usually tested for H. pylori and get treated if they have it.
Diet can affect the risk of stomach cancer. A diet low in fresh fruit and vegetables or high in salt can increase risk. Eating a lot of processed meats and foods that are smoked or pickled can also increase risk. The number of people in the UK who develop stomach cancer is decreasing, probably because refrigeration means we eat more fresh foods.
Smoking increases the risk of stomach cancer. The longer a person smokes for and the more cigarettes they smoke, the greater the risk. The risk reduces when people stop smoking.
People who are very overweight have an increased risk of cancer in the area where the stomach joins with the gullet (esophagus). This area is called the gastro-esophageal junction (GOJ).
Sometimes, acid from the stomach can flow back up into the gullet, causing indigestion and heartburn. Many people have this condition without it causing cancer. But, people with constant and more troublesome acid reflux over a long time may have an increased risk of stomach cancer.
Changes to the stomach lining
Conditions such as atrophic gastritis and pernicious anemia cause changes to the stomach lining and can increase risk.
Stomach surgery for another condition (such as an ulcer)
Removing part of the stomach reduces stomach acid. This means you have less protection from bacteria such as H. pylori.
People who have a brother, sister or parent with stomach cancer may have a higher than average risk. This may be because close family members share some risk factors for stomach cancer such as eating a similar diet or having H. pylori infection. But, shared genes may also play a small part.
In a very small number of families, an inherited cancer gene increases the risk of stomach cancer. In families with an inherited cancer gene, there may be two or more people on the same side of the family with stomach cancer or related cancers (such as bowel or womb cancer). If someone has an inherited cancer gene, they are also more likely to develop stomach cancer at a younger age (under 50).
The early symptoms of stomach cancer are similar to the symptoms of some common stomach conditions. It’s important to get them checked. Your doctor can arrange tests if necessary.
The early symptoms of stomach cancer include:
• heartburn or indigestion that doesn’t go away
• burping a lot
• having no appetite
• feeling full after eating only a small amount.
Other possible symptoms are:
• pain in the upper tummy area
• losing weight
• being sick
• having difficulty swallowing
• blood in your stools (bowel motions) or black stools
• feeling tired and sometimes breathless (due to anemia, which is a reduced number of red blood cells).
If you are over 55 and suddenly develop indigestion that doesn’t go away, you should always have an endoscopy.